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Üstündağ S, Yeşilbalkan ÖU, Kabay SC. The effect of a mobile education application (MobilMS) developed for multiple sclerosis patients in Turkey on symptom management and quality of life: A randomized controlled study. Mult Scler Relat Disord 2024; 81:105342. [PMID: 38091808 DOI: 10.1016/j.msard.2023.105342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/12/2023] [Accepted: 11/24/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND Multiple sclerosis (MS) is a neurodegenerative disease that affects the central nervous system (CNS) and is caused by immune dysfunction. MS results in a variety of symptoms that affect physical, emotional, social, and cognitive functioning. Effective symptom management is a critical factor in improving the quality of life (QoL) of patients with MS. PURPOSE To determine the effects of a comprehensive mobile education application developed for Turkish patients with MS on symptom management and QoL. METHODS The study was conducted as a randomized controlled trial and included 63 patients with MS older than 18 years who had an Expanded Disability Status Scale score of ≤6 and were actively using smart phones (intervention group, n = 31; control group, n = 32). Data were collected using a patient information form, the Multiple Sclerosis-Related Symptom (MS-RS) checklist, the Multiple Sclerosis Quality of Life Scale (MSQoL-54), and the Multiple Sclerosis Treatment Adherence Questionnaire (MS-TAQ). The scales were administered three times: at baseline, first month, and third month. Patients with MS in the intervention group were followed up for three months using MobilMS. RESULTS In the intervention group, the mean rating of MobilMS was 8.74±1.29. Most patients indicated that MobilMS was an "informative and useful application". None of the patients in the study reported any side effects or difficulties when using MobilMS application. The mean MSQL-54 score of the intervention group was significantly higher compared to that of the control group at the first and third months (p = 0.001). The mean scores on the MS-RS checklist (p = 0.985), MS-TAQ subscale, Disease modifying therapies (DMT) barriers (p = 0.237), DMT side effects (p = 0.994), DMT coping strategies (p = 0.469), and Missing Doze Rate (MDR) (p = 0.765) were lower in the intervention group than in the control group, but these results were not statistically significant. CONCLUSION The results of the study showed that MobilMS was highly appreciated, accepted, and used by patients with MS. MobilMS has the potential to meet the requirements for a free and accessible symptom management tool for patients with MS. The innovative MobilMS-based education intervention for support and symptom management is recommended as part of supportive care for this patient population. It is hoped that this study will pave the way for future studies on the utility of mobile applications for symptom management in patients with MS.
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Affiliation(s)
- Sema Üstündağ
- Faculty of Health Sciences, Nursing Department, Kütahya Health Sciences University, Kütahya, Turkey.
| | | | - Sibel Canbaz Kabay
- Faculty of Medicine, Department of Neurology, Dokuz Eylül University, İzmir, Turkey
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Genova HM, Chen MH, Botticello A, Voelbel G, Kim G, Elsayed HE, Myszko Z, DeLuca J, McGrath RE, Arnett P, Goverover Y. An Examination of Positive and Negative Outcomes During the COVID-19 Pandemic Among Persons With Multiple Sclerosis. Am J Occup Ther 2023; 77:7706205090. [PMID: 38015490 DOI: 10.5014/ajot.2023.050287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Abstract
IMPORTANCE This study provides information to clinicians about how persons with MS coped in both positive and negative ways during a potentially traumatic experience (the coronavirus disease 2019 [COVID-19] pandemic), which will help clinicians to provide better services to this population in the face of stressful events. OBJECTIVE To describe both positive and negative outcomes among persons with multiple sclerosis (MS) and to examine whether resilience and social support were related to positive and negative outcomes during the peak of the pandemic. DESIGN An online survey administered during the COVID-19 pandemic. PARTICIPANTS Participants were 74 individuals with MS and 104 healthy controls (HCs) recruited through social media and community support groups. OUTCOMES AND MEASURES The survey included questionnaires that assessed both positive and negative responses to the pandemic, including benefit finding, loneliness, and distress. Resilience and social support were also assessed. RESULTS Differences were noted between persons with MS and HCs on negative but not positive outcomes. Better social support and resilience were related to positive outcomes. CONCLUSIONS AND RELEVANCE Both persons with MS and HCs were similar in benefit finding and stress management. However, negative outcomes were worse in the MS group. Our findings shed light on the importance of individuals with MS adopting a positive outlook to help during times of adversity. What This Article Adds: Among persons with disabilities such as multiple sclerosis, finding benefits during stressful times can be a potential coping mechanism. Furthermore, resilience and social support should be taken into account to moderate the effects of adverse events.
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Affiliation(s)
- Helen M Genova
- Helen M. Genova, PhD, is Associate Director, Center for Autism Research, and Director, Social Cognition and Neuroscience Laboratory, Kessler Foundation, East Hanover, NJ, and Associate Professor, Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers, the State University of New Jersey, Newark
| | - Michelle H Chen
- Michelle H. Chen, PhD, is Assistant Professor, Department of Neurology, Robert Wood Johnson Medical School, Rutgers, the State University of New Jersey, New Brunswick
| | - Amanda Botticello
- Amanda Botticello, PhD, MPH, is Associate Director, Centers for Outcomes & Assessment Research, Kessler Foundation, East Hanover, NJ, and Vice Chair of Research Education, Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers, the State University of New Jersey, Newark
| | - Gerald Voelbel
- Gerald Voelbel, PhD, is Associate Professor, Department of Occupational Therapy, New York University, New York
| | - Grace Kim
- Grace Kim, PhD, is Associate Professor, Department of Occupational Therapy, New York University, New York
| | - Heba E Elsayed
- Heba E. Elsayed, MD, is Associate Research Scientist, Kessler Foundation, East Hanover, NJ
| | - Zuzanna Myszko
- Zuzanna Myszko, BA, is Doctoral Student, Montclair State University, Montclair, NJ
| | - John DeLuca
- John DeLuca, PhD, is Senior Vice President for Research and Training, Kessler Foundation, East Hanover, NJ, and Professor, Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers, the State University of New Jersey, Newark
| | - Robert E McGrath
- Robert E. McGrath, PhD, is Professor, Psychology Department, School of Psychology and Counseling, Fairleigh Dickinson University, Teaneck, NJ
| | - Peter Arnett
- Peter Arnett, PhD, is Professor, Psychology Department, Pennsylvania State University, University Park
| | - Yael Goverover
- Yael Goverover, PhD, is Visiting Professor, Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers, the State University of New Jersey, Newark, and Professor, Department of Occupational Therapy, New York University, New York;
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Lynch S, Baker S, Hunt S, Thuringer A, Jassam Y, Bruce J. The Impact of COVID-19 on the Lives of Individuals With Multiple Sclerosis: 1 Year Into the Pandemic. Int J MS Care 2022; 24:139-144. [PMID: 35645628 PMCID: PMC9135365 DOI: 10.7224/1537-2073.2021-099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
BACKGROUND The COVID-19 pandemic resulted in implementation of restrictive public health policies requiring people to limit or avoid interaction with others. These policies also had an economic impact. Individuals with multiple sclerosis (MS) already experience higher incidences of depression, anxiety, social isolation, and job loss, and the continuing pandemic may exacerbate these. METHODS Between November 2, 2020, and February 12, 2021, 233 individuals with MS completed the Hospital Anxiety and Depression Scale, the modified Medical Outcomes Study Social Support Survey, the Centers for Disease Control/National Institutes of Health Common Data Element Repository economic impact questions, and study team-designed questions about social and family relationships and adherence to public health policies. RESULTS Study participants reported high rates of mask wearing, good hand hygiene, and limited interactions with those outside their homes. They felt isolated from family they did not live with, friends, and coworkers. The frequency of conflicts with their spouses/partners increased "a little" among 20% of respondents, but overall relationships with housemates were "unchanged" or "a little better." Ninety-one percent of participants reported experiencing no financial impact. On the Hospital Anxiety and Depression Scale, 16.0% of 218 respondents reported depressive symptoms and 26.8% of 216 reported symptoms of anxiety above the commonly accepted clinically significant cutoff points. Only 3.4% of participants reported contracting SARS-CoV-2. CONCLUSIONS During the first year of the pandemic, this study found no pronounced impact on the emotional, social, or economic stability of the individuals with MS it surveyed. It seems that these study participants adapted to the restrictions created by the pandemic and, by adhering to guidelines, protected themselves from contracting SARS-CoV-2.
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Affiliation(s)
- Sharon Lynch
- From the Department of Neurology (SL, SB, AT), University of Kansas Medical Center, Kansas City, KS, USA
| | - Sara Baker
- From the Department of Neurology (SL, SB, AT), University of Kansas Medical Center, Kansas City, KS, USA
| | - Suzanne Hunt
- From the The Department of Biostatistics and Data Science (SH), University of Kansas Medical Center, Kansas City, KS, USA
| | - Amanda Thuringer
- From the Department of Neurology (SL, SB, AT), University of Kansas Medical Center, Kansas City, KS, USA
| | - Yasir Jassam
- From the Pickup Family Neurosciences Institute, Hoag Memorial Hospital Presbyterian, Newport Beach, CA, USA (YJ)
| | - Jared Bruce
- From the Department of Biomedical and Health Informatics, School of Medicine, University of Missouri–Kansas City, Kansas City, MO, USA (JB)
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Effects of quarantine applied during the COVID-19 pandemic on mental health and quality of life in patients with multiple sclerosis and healthy controls. Neurol Sci 2022; 43:2263-2269. [PMID: 35061136 PMCID: PMC8777171 DOI: 10.1007/s10072-022-05901-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/14/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND The coronavirus outbreak, which emerged in Wuhan, China, in late 2019 and spread to the world, has changed each of our lives. OBJECTIVE To investigate the effects of quarantine on depression, anxiety, sleep quality, fatigue, and SF-36 of multiple sclerosis (MS) patients during the COVID-19 outbreak and differences between healthy controls (HC). METHODS Eighty-six MS patients and 65 HC patients were included in the study. Participants filled out the various scales through face-to-face interviews for mental health assessment from January 15 to February 15, 2021. RESULTS When both groups were compared in terms of BECK-D inventory (p < 0.001), BECK-A inventory (p = 0.010), and FS (p < 0.001), the patient group had significantly higher results. Physical functioning (p < 0.001), physical role limitation (p = 0.001), energy vitality rates (p = 0.010), and general health perception (p < 0.001) were higher in the HC group. When MS patients were divided according to EDSS scores, BECK-A (p < 0.001), BECK-D (p = 0.001), and PSQI (p = 0.006) scores of the patients with EDSS > 3 were higher, while emotional role restriction rates (p = 0.006), energy and vitality (p = 0.018), and pain (p = 0.005) were significantly lower than those with EDSS ≤ 3. When MS patients were divided into two groups as who had COVID-19 and who did not and compared SF-36 subscale scores, pain, (p = 0.049) and mental status (p = 0.030) were obtained significant differences in the two groups. CONCLUSIONS Our study revealed that MS patients, who are more susceptible to the new 'normal' that emerged during the pandemic period, are among the priority groups that should be supported in terms of mental health as well as physical health.
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Esteve-Ríos A, García-Sanjuán S, Juliá-Sanchis R, Monasor-Ortolá D, Cabañero-Martínez MJ. Experience of women with multiple sclerosis during the period of compulsory home confinement due to COVID-19 in Spain. Women Health 2022; 62:214-222. [DOI: 10.1080/03630242.2022.2044974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Antonio Esteve-Ríos
- Nurse and researcher in nursing Department, University of Alicante, Alicante, Spain
| | - Sofía García-Sanjuán
- Nurse and researcher in nursing Department, University of Alicante, Alicante, Spain
| | - Rocío Juliá-Sanchis
- Nurse and researcher in nursing Department, University of Alicante, Alicante, Spain
| | - David Monasor-Ortolá
- Nurse and researcher in nursing Department, University of Alicante, Alicante, Spain
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Altieri M, Capuano R, Bisecco A, d'Ambrosio A, Buonanno D, Tedeschi G, Santangelo G, Gallo A. The psychological impact of Covid-19 pandemic on people with Multiple Sclerosis: a meta-analysis. Mult Scler Relat Disord 2022; 61:103774. [PMID: 35381533 PMCID: PMC8956358 DOI: 10.1016/j.msard.2022.103774] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/24/2021] [Accepted: 03/24/2022] [Indexed: 12/22/2022]
Abstract
Background Covid-19 pandemic caused relevant psychological consequences in the general population. Since people with Multiple Sclerosis (pwMS) are usually at higher risk of psychological distress than age-matched healthy controls (HC), a meta-analytic study was conducted, aimed at evaluating i) differences between pwMS and HC in the psychological variables during the pandemic, ii) differences in the levels of anxiety, depression, stress, sleep disturbances and quality of life before and during the Covid-19 pandemic in pwMS. Methods The literature search on three electronic databases yielded 196 studies (113 after the duplicates removal). Seven studies compared psychological variables between pwMS and HC during the pandemic, while seven studies evaluated the pre- vs during the pandemic differences in pwMS. The following outcomes were selected: depression, anxiety, physical QoL, mental QoL, stress, sleep quality/disturbances. Mean weighted effect sizes (ES) were calculated using Hedges'g, via Prometa3 software. Results During the pandemic, pwMS showed higher levels of depression (g = 0.51, p=.001), anxiety (g = 0.41, p=.032), and stress (g = 0.51, p=.016) compared to HC. The comparison on psychological outcomes before and during the pandemic in pwMS revealed no significant increase during the pandemic on levels of anxiety (g = 0.08, p=.380), depression (g = 0.02, p=.772), mental QoL (g= -0.14, p=.060), physical QoL (g = 0.00, p=.986), whereas sleep quality deteriorated during the pandemic (g = 0.52, p<.001). Conclusions In agreement with pre-pandemic literature, pwMS showed higher levels of psychological distress than HC also during the Covid-19 pandemic. Contrariwise, longitudinal studies revealed that, in pwMS, the only psychological-associated variable that worsened significantly was the sleep quality, but this outcome was evaluated only in two studies. Future studies will have to assess/evaluate the long-term psychological consequences of the pandemic on pwMS.
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Affiliation(s)
- Manuela Altieri
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, (NA), Italy; Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta (CE), Italy.
| | - Rocco Capuano
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, (NA), Italy
| | - Alvino Bisecco
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, (NA), Italy
| | - Alessandro d'Ambrosio
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, (NA), Italy
| | - Daniela Buonanno
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, (NA), Italy
| | - Gioacchino Tedeschi
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, (NA), Italy
| | - Gabriella Santangelo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta (CE), Italy
| | - Antonio Gallo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, (NA), Italy.
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Zarghami A, Hussain MA, Campbell JA, Ezegbe C, van der Mei I, Taylor BV, Claflin SB. Psychological impacts of COVID-19 pandemic on individuals living with multiple sclerosis: A rapid systematic review. Mult Scler Relat Disord 2022; 59:103562. [PMID: 35149393 PMCID: PMC8786442 DOI: 10.1016/j.msard.2022.103562] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 01/18/2022] [Accepted: 01/23/2022] [Indexed: 12/04/2022]
Abstract
INTRODUCTION The global spread of COVID-19 has raised concerns about its possible impact on mental health. People living with multiple sclerosis (PwMS) are considered potentially vulnerable to the mental health effects of the pandemic, as they may be subject to increased social isolation. AIM To systematically review the current evidence on the impact of the COVID-19 pandemic on mental health outcomes among PwMS. METHOD We searched four major databases (Medline, EMBASE, PsychInfo and Scopus) and the WHO Global Health COVID-19 research database. We included peer-reviewed primary research studies using validated health-related quality of life (HRQOL) and psychometric screening tools to evaluate mental health outcomes among PwMS during the COVID-19 pandemic. Studies reporting data on the prevalence of mental health disorders, severity of psychological symptoms and contributing demographic and clinical factors for PwMS during the COVID-19 pandemic were included. RESULTS Our initial search yielded 268 records; 19 studies (13 cross-sectional, 6 longitudinal) were included. Most were conducted during a peak in the pandemic in the host country via an online platform. The main mental health outcomes were depression, anxiety, stress, sleep quality and HRQOL. The included studies used a variety of outcome assessment tools and study designs. The prevalence of mental health issues such as depression, anxiety and stress were high among PwMS during the pandemic. In addition, compared to control populations, PwMS experienced more severe symptoms of depression and stress during the COVID-19 outbreak. However, results from longitudinal studies demonstrate that the severity of mental health symptoms among PwMS during the pandemic were not significantly different compared with the pre-pandemic period. CONCLUSION Although mental health issues such as anxiety and depression were common among PwMS during the pandemic, current evidence suggests that mental health among PwMS has not been significantly affected by pandemic-related restrictive measures. Instead, the observed differences may be the result of pre-pandemic differences in prevalence and severity. Where possible, future studies should seek to address the methodological issues identified in the included studies to ensure that data collected during the pandemic can be synthesized into recommendations for policy and practice.
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Affiliation(s)
- Amin Zarghami
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Mohammad A Hussain
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Julie A Campbell
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Chigozie Ezegbe
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Ingrid van der Mei
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Bruce V Taylor
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Suzi B Claflin
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
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Declerck L, Loiselet C, Kaux JF, Lejeune T, Vanderthommen M, Stoquart G. Effect of the COVID-19 pandemic lockdown on physical activity of individuals with a spinal cord injury in Belgium: observational study. Ann Phys Rehabil Med 2022; 65:101649. [PMID: 35235876 PMCID: PMC8882421 DOI: 10.1016/j.rehab.2022.101649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 02/17/2022] [Accepted: 02/19/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Louise Declerck
- Université catholique de Louvain, Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Neuromusculoskeletal Lab (NMSK), Brussels, Belgium
| | - Céline Loiselet
- Faculté des Sciences de la motricité, Université Catholique de Louvain, Louvain-la-neuve, Belgium
| | - Jean-François Kaux
- Département de médecine et de traumatology du sportif SportS², FIFA Medical Centre of Excellence, FIMS Collaborative Centre of Sports Medicine and ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Centre hospitalier universitaire de Liège, Liège, Belgium; Départment des sciences de la motricité, Université de Liège, Liège, Belgium
| | - Thierry Lejeune
- Départment des sciences de la motricité, Université de Liège, Liège, Belgium; Cliniques universitaires Saint-Luc, Service de médecine physique et réadpatation, Brussels, Belgium.
| | - Marc Vanderthommen
- Départment des sciences de la motricité, Université de Liège, Liège, Belgium
| | - Gaëtan Stoquart
- Université catholique de Louvain, Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Neuromusculoskeletal Lab (NMSK), Brussels, Belgium; Cliniques universitaires Saint-Luc, Service de médecine physique et réadpatation, Brussels, Belgium
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Yeni K, Tulek Z, Terzi M. A year with the fear of COVID-19 in multiple sclerosis patients: Examination of depression, sleep quality and quality of life before and after the pandemic. Mult Scler Relat Disord 2022; 57:103370. [PMID: 35158434 PMCID: PMC8579733 DOI: 10.1016/j.msard.2021.103370] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/19/2021] [Accepted: 11/03/2021] [Indexed: 11/04/2022]
Abstract
Background The COVID-19 outbreak, which has caused great fear and has affected many aspects of life even in healthy individuals, could become more threatening for people with multiple sclerosis (PwMS). Aim The aim of the present study was to evaluate depression, sleep and quality of life before and one year after the COVID-19 pandemic in PwMS and the association between the fear of COVID-19 and these parameters. Methods A total of 89 PwMS and 262 healthy controls were included in this descriptive cross-sectional study. The study compared the data collected before the pandemic with the data collected online approximately one year after the onset of the pandemic. The Fear of COVID-19 Scale (FCV-19S), the Worry and Anxiety Questionnaire (WAQ), the Beck Depression Inventory (BDI), the Pittsburgh Sleep Quality Index (PSQI) and the MS Quality of life scale (MSQoL-54) were used as data collection tools. Results The mean age of the patients was 41.08 (±10.2) years; 62% were female and half (50.6%) of the patients were not working. The mean EDSS and the mean duration of diagnosis were found to be 1.33(±1.6) and 7.73(±6.1), respectively. The mean age of the control group was 38.08 (±11.4) and 51.5% were female. In both groups, social (PwMS 79.8% vs HC 89.3%) and psychological (PwMS 61.8% vs HC 51.9%) fields were found to have been affected by the COVID-19 pandemic most. Of the patients, 19% reported that the frequency of exacerbations increased during the pandemic. In the patient group, the fear of coronavirus (p=0.808) and the sleep quality (p=0.906) were found not to be different to those in control group; however, the anxiety (p=0.001) and depression (p=0.001) levels were determined to be significantly higher. Compared to the pre-pandemic period, the sleep quality of the patients was seen to be impaired during the pandemic (p<0.05); however, the depression scores were seen not to change (p>0.05). Although there were improvements in energy/vitality (p<0.001) and sexual function (p=0.002) scale scores, compared to the pre-pandemic period, deterioration in many sub-dimensions of quality of life was detected. Multiple regression analysis demonstrated that the anxiety, depression, and the sleep problems were predictors of both the physical health (p<0.001) and the mental health (p<0.001) sub-dimensions. The fear of coronavirus was determined not to have a significant effect on the quality of life (p>0.05). Conclusion It was determined that PwMS and were psychosocially affected by the COVID-19 pandemic, and had a significant deterioration in sleep quality at the end of a year spent with the pandemic. In addition, there was a deterioration in depression scores, although it was not statistically significant. Considering the fact that many subdimensions of quality of life, especially those associated with mental health, were impaired, it can be said that providing psychosocial support to patients is an important necessity.
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Affiliation(s)
- Kubra Yeni
- Faculty of Health Sciences, Ondokuz Mayis University, Samsun, Turkey.
| | - Zeliha Tulek
- Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Murat Terzi
- Faculty of Health Sciences, Ondokuz Mayis University, Samsun, Turkey; Department of Neurology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
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Robinson E, Sutin AR, Daly M, Jones A. A systematic review and meta-analysis of longitudinal cohort studies comparing mental health before versus during the COVID-19 pandemic in 2020. J Affect Disord 2022; 296:567-576. [PMID: 34600966 PMCID: PMC8578001 DOI: 10.1016/j.jad.2021.09.098] [Citation(s) in RCA: 532] [Impact Index Per Article: 266.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/09/2021] [Accepted: 09/27/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Increases in mental health problems have been observed during the COVID-19 pandemic. The objectives were to examine the extent to which mental health symptoms changed during the pandemic in 2020, whether changes were persistent or short lived, and if changes were symptom specific. METHODS Systematic review and meta-analysis of longitudinal cohort studies examining changes in mental health among the same group of participants before vs. during the pandemic in 2020. RESULTS Sixty-five studies were included. Compared to pre-pandemic outbreak, there was an overall increase in mental health symptoms observed during March-April 2020 (SMC = .102 [95% CI: .026 to .192]) that significantly declined over time and became non-significant (May-July SMC = .067 [95% CI: -.022 to .157]. Compared to measures of anxiety (SMC = 0.13, p = 0.02) and general mental health (SMC = -.03, p = 0.65), increases in depression and mood disorder symptoms tended to be larger and remained significantly elevated in May-July [0.20, 95% CI: .099 to .302]. In primary analyses increases were most pronounced among samples with physical health conditions and there was no evidence of any change in symptoms among samples with a pre-existing mental health condition. LIMITATIONS There was a high degree of unexplained heterogeneity observed (I2s > 90%), indicating that change in mental health was highly variable across samples. CONCLUSIONS There was a small increase in mental health symptoms soon after the outbreak of the COVID-19 pandemic that decreased and was comparable to pre-pandemic levels by mid-2020 among most population sub-groups and symptom types.
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Affiliation(s)
- Eric Robinson
- Department of Psychology, University of Liverpool, Eleanor Rathbone Building, Liverpool L69 7ZA, UK.
| | - Angelina R Sutin
- Department of Psychology, Maynooth University, Co., Kildare, Ireland
| | - Michael Daly
- Department of Psychology, Maynooth University, Co., Kildare, Ireland
| | - Andrew Jones
- Department of Psychology, University of Liverpool, Eleanor Rathbone Building, Liverpool L69 7ZA, UK
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Heidler F, Baldt J, Frahm N, Langhorst SE, Mashhadiakbar P, Streckenbach B, Zettl UK, Richter J. Vaccination Setting of Patients with Autoimmune Diseases in Times of Severe Acute Respiratory Syndrome Coronavirus Type 2 Pandemic Using the Example of Multiple Sclerosis Patients: A Longitudinal Multicenter Study. Eur Neurol 2021; 85:104-111. [PMID: 34743082 DOI: 10.1159/000519582] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 08/12/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection represents a serious health risk, especially in chronically ill people. Multiple sclerosis (MS) is the most common chronic immune-mediated neurological disease. Vaccinations play an important role in the therapeutic MS management. This study aimed at determining MS patients' attitudes toward vaccinations and governmental measures before and during the SARS-CoV-2 pandemic, including associations with sociodemographic and clinical variables. METHODS In a longitudinal, multicenter study, 200 MS patients were investigated regarding their vaccination attitudes before and after the first wave of the SARS-CoV-2 pandemic. Data on vaccination status and burden (physical, psychological, and social) experienced as caused by the pandemic and related governmental safety measures were registered. RESULTS Patients with progressive MS felt significantly more pandemic-burdened than patients with relapsing-onset MS (p < 0.001). Older patients were more frequently willing to get vaccinated against SARS-CoV-2 than younger patients (p < 0.001). After the first pandemic wave, patients with pre-pandemic willingness to comply with vaccination recommendations were more likely to accept recommended standard vaccinations (60% vs. 36%) and a possible SARS-CoV-2 vaccination than pre-pandemic nonwilling patients (66.7% vs. 42.0%). CONCLUSIONS The vaccination topic was not immediately present in many patients before the pandemic. MS patients need comprehensive and understandable education meeting their concerns using evidence-based and convincing arguments on the subject of vaccination, particularly younger patients. Older patients are already more often willing to become vaccinated. Complete vaccination status is necessary to avoid multiple infections.
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Affiliation(s)
| | - Julia Baldt
- Neuroimmunology Section, Department of Neurology, University Medical Center of Rostock, Rostock, Germany
| | - Niklas Frahm
- Neuroimmunology Section, Department of Neurology, University Medical Center of Rostock, Rostock, Germany
| | - Silvan Elias Langhorst
- Neuroimmunology Section, Department of Neurology, University Medical Center of Rostock, Rostock, Germany
| | - Pegah Mashhadiakbar
- Neuroimmunology Section, Department of Neurology, University Medical Center of Rostock, Rostock, Germany
| | - Barbara Streckenbach
- Neuroimmunology Section, Department of Neurology, University Medical Center of Rostock, Rostock, Germany
| | - Uwe Klaus Zettl
- Neuroimmunology Section, Department of Neurology, University Medical Center of Rostock, Rostock, Germany
| | - Jörg Richter
- Ecumenic Hainich Hospital gGmbH, Mühlhausen, Germany.,Faculty of Health Sciences, University of Hull, Hull, United Kingdom
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12
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Ondek K, Nasirishargh A, Dayton JR, Nuño MA, Cruz-Orengo L. Strain and sex differences in somatosensation and sociability during experimental autoimmune encephalomyelitis. Brain Behav Immun Health 2021; 14:100262. [PMID: 34589768 PMCID: PMC8474462 DOI: 10.1016/j.bbih.2021.100262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/15/2021] [Accepted: 04/18/2021] [Indexed: 12/01/2022] Open
Abstract
Multiple Sclerosis (MS) is an immune-mediated disease that results in major locomotor deficits. However, recent studies have revealed that fatigue, slow processing speed, and memory impairment are the top variables impacting employment status for MS patients. These suggest that cognitive effects may have a greater impact on productivity, lifestyle, and quality of life than do disease-related motor deficits. However, these debilitating non-locomotive effects have been largely overlooked in rodent models of the disease, such as experimental autoimmune encephalomyelitis (EAE). We hypothesized that murine EAE can also be used to assess non-locomotive dysfunctions (mood, sociability, muscle strength, and balance), as well as potential biases in these dysfunctions due to sex and/or strain. We actively immunized male and female C57BL/6 (B6) and SJL mice for EAE and evaluated their performance on the Deacon's weight grip test, Kondziela's inverted screen test, Hall's rope grip test, manual von Frey test for somatic nociception, and a three-chamber social preference paradigm. We hypothesized that EAE progression is associated with changes in muscle strength, balance, pain, and sociability and that these variations are linked to sex and/or strain. Our results indicate that strain but not sex influenced differences in muscle strength and balance during EAE, and both sex and strain have an impact on mechanical nociception, regardless of EAE disease status. Furthermore, both sex and strain had complex effects on differences in sociability. In conclusion, testing these additional modalities during EAE helps to unveil other signs and symptoms that could be used to determine the efficacy of a drug or treatment in the modulation of a MS-like behavior.
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Affiliation(s)
- Katelynn Ondek
- University of California, Davis. Department of Anatomy, Physiology & Cell Biology, School of Veterinary Medicine, 1089 Veterinary Medicine Drive, Davis, CA, 95616, USA
| | - Aida Nasirishargh
- University of California, Davis. Department of Anatomy, Physiology & Cell Biology, School of Veterinary Medicine, 1089 Veterinary Medicine Drive, Davis, CA, 95616, USA
| | - Jacquelyn R. Dayton
- University of California, Davis. Department of Anatomy, Physiology & Cell Biology, School of Veterinary Medicine, 1089 Veterinary Medicine Drive, Davis, CA, 95616, USA
| | - Miriam A. Nuño
- University of California, Davis. Department of Public Health, Division of Biostatistics, School of Medicine, Public Health/Medical Sciences Bldg. 1-C, Davis, CA 95616, USA
| | - Lillian Cruz-Orengo
- University of California, Davis. Department of Anatomy, Physiology & Cell Biology, School of Veterinary Medicine, 1089 Veterinary Medicine Drive, Davis, CA, 95616, USA
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13
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Poli S, Rimondini M, Gajofatto A, Mazzi MA, Busch IM, Gobbin F, Schena F, Del Piccolo L, Donisi V. "If You Can't Control the Wind, Adjust Your Sail": Tips for Post-Pandemic Benefit Finding from Young Adults Living with Multiple Sclerosis. A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084156. [PMID: 33919974 PMCID: PMC8070973 DOI: 10.3390/ijerph18084156] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 12/22/2022]
Abstract
The COVID-19 outbreak has impacted the wellbeing of people worldwide, potentially increasing maladaptive psychological responses of vulnerable populations. Although young adults with multiple sclerosis (yawMS) might be at greater risk of developing psychological distress linked to the pandemic, they might also be able to adapt to stress and find meaning in adverse life events. The aim of the present study was to explore benefit finding in response to the pandemic in a sample of yawMS. As part of a larger project, data were collected using a cross-sectional, web-based survey. Benefit finding was analysed using a qualitative thematic approach; descriptive and inferential statistics were performed to describe the sample and compare sub-groups. Out of 247 respondents with mostly relapsing-remitting MS, 199 (31.9 ± 6.97 years) reported at least one benefit. Qualitative analysis showed that during the pandemic yawMS found benefits related to three themes: personal growth, relational growth, and existential growth. No differences in benefit finding were found between age sub-groups (18–30 vs. 31–45). Participants reported a wide range of benefits, some of which seem to be specific to MS or the pandemic. Results have been transformed into tips to be introduced in clinical practice to promote resilience in yawMS through meaning making.
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14
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Al Jumah M, Abulaban A, Aggad H, Al Bunyan R, AlKhawajah M, Al Malik Y, Almejally M, Alnajashi H, Alshamrani F, Bohlega S, Cupler EJ, ElBoghdady A, Makkawi S, Qureshi S, Shami S. Managing multiple sclerosis in the Covid19 era: a review of the literature and consensus report from a panel of experts in Saudi Arabia. Mult Scler Relat Disord 2021; 51:102925. [PMID: 33857897 PMCID: PMC7992311 DOI: 10.1016/j.msard.2021.102925] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 03/10/2021] [Accepted: 03/21/2021] [Indexed: 12/17/2022]
Abstract
Disease-modifying therapies (DMT) for relapsing-remitting MS (RRMS) act on the immune system, suggesting a need for caution during the SARS-CoV2/Covid-19 pandemic. A group of experts in MS care from Saudi Arabia convened to consider the impact of Covid-19 on MS care in that country, and to develop consensus recommendations on the current application of DMT therapy. Covid-19 has led to disruption to the care of MS in Saudi Arabia as elsewhere. The Expert Panel considered a DMT's overall tolerability/safety profile to be the most important consideration on whether or not to prescribe at this time. Treatment can be started or continued with interferon beta, teriflunomide, dimethyl fumarate, or natalizumab, as these DMTs are not associated with increased risk of infection (there was no consensus on the initiation of other DMTs). A consensus also supported continuing treatment regimens with fingolimod (or siponimod) and cladribine tablets for a patient without active Covid-19. No DMT should be imitated in a patient with active Covid-19, and (only) interferon beta could be continued in the case of Covid-19 infection. Vaccination against Covid-19 is a therapeutic priority for people with MS. New treatment should be delayed for 2–4 weeks for vaccination. Where treatment is already ongoing, vaccination against Covid-19 should be administered immediately without disruption of treatment (first-line DMTs, natalizumab, fingolimod), when lymphocytes have recovered sufficiently (cladribine tablets, alemtuzumab) or 4 months after the last dose (ocrelizumab). These recommendations will need to be refined and updated as new clinical evidence in this area emerges.
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Affiliation(s)
- Mohammed Al Jumah
- Neurology Department, King Fahad Medical City, Riyadh, Saudi Arabia.
| | - Ahmad Abulaban
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Department of Medicine, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Hani Aggad
- Neurology Department, King Abdallah Medical Complex, Jeddah, Saudi Arabia
| | - Reem Al Bunyan
- Department of Neurology, Neurosciences Center, King Fahad Specialist Hospital Dammam, Saudi Arabia
| | - Mona AlKhawajah
- Department of Neurosciences, King Faisal Specialist Hospital and Research Center, Riyadh Saudi Arabia
| | - Yaser Al Malik
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; Division of Neurology, King Abdulaziz Medical City (National Guard Health Affairs), Riyadh, Saudi Arabia
| | - Mousa Almejally
- Neurology Department, Heraa General Hospital, Makkah, Saudi Arabia
| | - Hind Alnajashi
- Neurology Division, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Saeed Bohlega
- Department of Neurosciences, King Faisal Specialist Hospital and Research Center, Jeddah Saudi Arabia
| | - Edward J Cupler
- Department of Neurosciences, King Faisal Specialist Hospital and Research Center, Jeddah Saudi Arabia
| | - Ahmed ElBoghdady
- Merck Serono Middle East FZ LTD, Riyadh, Saudi Arabia, an affiliate of Merck KGaA, Darmstadt, Germany
| | - Seraj Makkawi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia; Department of Medicine, Ministry of the National Guard-Health Affairs, Jeddah, Saudi Arabia
| | - Shireen Qureshi
- Neurology Department, Johns Hopkins Aramco Healthcare (JHAH), Dhahran, Saudi Arabia
| | - Sahar Shami
- Itkan Health Consulting, Riyadh, Saudi Arabia
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15
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Physical Exercise Moderates the Effects of Disability on Depression in People with Multiple Sclerosis during the COVID-19 Outbreak. J Clin Med 2021; 10:jcm10061234. [PMID: 33809698 PMCID: PMC8002261 DOI: 10.3390/jcm10061234] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/10/2021] [Accepted: 03/15/2021] [Indexed: 12/14/2022] Open
Abstract
Physical disability impacts psychosocial wellbeing in people with multiple sclerosis. However, the role of physical activity in this context is still debated. By taking advantage of a previous survey, conducted online from 22 April to 7 May 2020, we performed a post-hoc analysis with the aim to assess the associations between disability, physical exercise, and mental health in multiple sclerosis. We retrieved the following data: (i) sociodemographic information, (ii) changes in lifestyle (including exercise), (iii) physical disability, as measured with the Patient-Determined Disease Steps scale, and (iv) anxiety feelings and depressive symptoms assessed via the items included in the Quality of Life in Neurological Disorders measurement system. Examination of the interaction plot showed that the effect of disability on depression, but not on anxious symptoms, was significant for all levels of physical exercise (low: b = 1.22, 95% C.I. 0.85, 1.58, p < 0.001; moderate: b = 0.95, 95% C.I. 0.66, 1.24, p < 0.001; and high: b = 0.68, 95% C.I. 0.24, 1.13, p = 0.003). Based on these data, we can conclude that disability significantly impacted depression during the COVID-19 pandemic, with physical activity playing a moderating role. Our results suggest that favoring exercise in multiple sclerosis (MS) would ameliorate psychological wellbeing regardless of the level of physical disability.
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16
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COVID-19 and disease-modifying therapies in patients with demyelinating diseases of the central nervous system: A systematic review. Mult Scler Relat Disord 2021; 50:102800. [PMID: 33578206 PMCID: PMC7845520 DOI: 10.1016/j.msard.2021.102800] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/21/2021] [Accepted: 01/25/2021] [Indexed: 12/12/2022]
Abstract
Introduction The Coronavirus disease-19 (COVID-19) pandemic continues to expand across the world. This pandemic has had a significant impact on patients with chronic diseases. Among patients with demyelinating diseases of the central nervous system (CNS), such as Multiple Sclerosis (MS) or Neuromyelitis Optica Spectrum Disorder (NMOSD), concerns remain about the potential impact of COVID-19 on these patients given their treatment with immunosuppressive or immunomodulatory therapies. In this study, we review the existing literature investigating the impact of disease-modifying therapies(DMT) on COVID-19 risks in this group of patients. Method For this systematic review, we searched PubMed from January 1, 2020, to December 3, 2020. The following keywords were used: “COVID-19” AND “Multiple Sclerosis” OR “Neuromyelitis Optica.” Articles evaluating COVID-19 in patients with demyelinating diseases of CNS were included. This study evaluates the different aspects of the DMTs in these patients during the COVID-19 era. Results and conclusion A total of 262 articles were found. After eliminating duplicates and unrelated research papers, a total of 84 articles met the final inclusion criteria in our study. Overall, the experiences of 2493 MS patients and 37 NMOSD patients with COVID-19 were included in this review. Among them, 46(1.8%) MS patients died(the global death-to-case ratio of Covid-19 was reported about 2.1%). Among DMTs, Rituximab had the highest mortality rate (4%). Despite controversies, especially concerning anti-CD20 monoclonal antibody therapies, a relation between DMT-use and COVID-19 disease- course was not found in many studies. This observation reinforces the recommendation of not stopping current DMTs. Other variables such as age, higher expanded disability status scale (EDSS) scores, cardiac comorbidities, and obesity were independent risk factors for severe COVID-19. Despite the risks of infection, most patients were willing to continue their DMT during the pandemic because of more significant concern about the risk of relapse or worsening MS symptoms. After the infection, an immune response's attenuation was seen in the patients on Fingolimod and anti-CD20 monoclonal antibodies. This may be a critical finding in future vaccinations.
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17
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Andrenelli E, Negrini F, De Sire A, Patrini M, Lazzarini SG, Ceravolo MG. Rehabilitation and COVID-19: a rapid living systematic review 2020 by Cochrane Rehabilitation Field. Update as of September 30th, 2020. Eur J Phys Rehabil Med 2020; 56:846-852. [PMID: 33118719 DOI: 10.23736/s1973-9087.20.06672-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION The COVID-19 outbreak response requires identifying and understanding the long-term consequences of this new pathology and how to manage these. This living systematic review presents the most current and seminal information coming from the scientific literature. It is the monthly update of the second edition of the rapid living systematic review 2020 conducted by Cochrane Rehabilitation REH-COVER Action Steering Committee. The aim of this review was to update the monthly COVID-19 and rehabilitation literature research up to September 30, 2020. EVIDENCE ACQUISITION Methodology described in the second edition of the rapid living systematic review 2020 conducted by Cochrane Rehabilitation REH-COVER action was applied. The most important medical databases were searched, and papers related to COVID-19 and rehabilitation were retrieved and summarized descriptively. EVIDENCE SYNTHESIS The database search retrieved 2526 publications. Duplicates were removed, and 1150 unique records were screened for inclusion. After screening titles, abstracts and full-texts, 37 papers were included in the present review. According to OCEBM 2011 levels of evidence table, most studies (78.4%) fall within the level of evidence 4 category, while the remainder (22.6%) are categorized as level of evidence 3. Most studies described patients in acute (51.4%) or subacute (35.0%) phase, while no studies described the chronic consequences of COVID-19. Just one study dealt with rehabilitation interventions regarding COVID-19, and two discussed reorganization of rehabilitative services. CONCLUSIONS The most recently published COVID-19 research focuses more on describing the clinical presentations and the natural history of the pathology, rather than rehabilitation interventions or service delivery. Studies with high levels of evidence regarding the efficacy of interventions, long-term monitoring, or new organization models remain lacking.
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Affiliation(s)
- Elisa Andrenelli
- Department of Experimental and Clinical Medicine, Politecnica delle Marche University, Ancona, Italy
| | | | - Alessandro De Sire
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy - .,Rehabilitation Unit, Mons. L. Novarese Hospital, Moncrivello, Vercelli, Italy
| | | | | | - Maria G Ceravolo
- Department of Experimental and Clinical Medicine, Politecnica delle Marche University, Ancona, Italy
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Donisi V, Gajofatto A, Mazzi MA, Gobbin F, Busch IM, Ghellere A, Rimondini M. Insights for Fostering Resilience in Young Adults With Multiple Sclerosis in the Aftermath of the COVID-19 Emergency: An Italian Survey. Front Psychiatry 2020; 11:588275. [PMID: 33692703 PMCID: PMC7938709 DOI: 10.3389/fpsyt.2020.588275] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 12/29/2020] [Indexed: 12/12/2022] Open
Abstract
Objective: Recent evidence has demonstrated that the COVID-19 pandemic is taking a toll on the mental health of the general population. The psychological consequences might be even more severe for patients with special healthcare needs and psychological vulnerabilities due to chronic diseases, such as multiple sclerosis (MS). Thus, we aimed to explore the psychological impact of this pandemic and of the subsequent healthcare service changes on young adults with MS living in Italy and to examine their coping strategies and preferences regarding psychological support in the aftermath of the pandemic. Methods: Data were collected using a cross-sectional, web-based survey advertised on social networks. We report both quantitative (descriptive statistics, t-tests, and one-way ANOVA) and qualitative data (inductive content analysis). Results: Two hundred and forty-seven respondents (mean age 32 ± 7 years), mainly with relapsing-remitting MS, from all Italian regions participated. Participants felt more worried, confused, sad, and vulnerable because of the disease "during" the pandemic in comparison to their self-evaluation of the period "before" the COVID-19 outbreak. Similarly, their perception of control over MS decreased "during" the pandemic in comparison to the retrospective evaluation of the period "before" the COVID-19 outbreak (p < 0.01). Canceled/postponed visits/exams were listed as the most frequent MS management changes, with modified/postponed pharmacological treatment representing the most stressful change. Psychological support in dealing with pandemic-related fears and improving MS acceptance and well-being was considered extremely important by almost 40% of the respondents. Different coping strategies were mentioned in the qualitative section of the survey, with social support, hobbies, and keeping busy being the most frequent ones. Conclusions: Considering the enormous impact of the pandemic on young adults with MS, we urge MS clinical centers to implement psychological support programs that address the potentially long-lasting psychological negative impact, thus fostering the therapeutic alliance that is being threatened by the infection prevention measures imposed during the pandemic, and promoting psychological resources for adaptively managing future waves of COVID-19.
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Affiliation(s)
- Valeria Donisi
- Section of Clinical Psychology, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Alberto Gajofatto
- Section of Neurology, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Maria Angela Mazzi
- Section of Clinical Psychology, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Francesca Gobbin
- Section of Neurology, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Isolde Martina Busch
- Section of Clinical Psychology, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Annamaria Ghellere
- Section of Clinical Psychology, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Michela Rimondini
- Section of Clinical Psychology, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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